Active NPI
Victoria Ann Purviance, LCPC
- Mental Health Counselor
- Hayden, ID
National Provider Identifier
1699907907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LCPC 3670
- Practice address
- 2151 W Hayden Ave
Hayden, ID 83835-7414 - Phone
- (208) 661-1776
- Fax
- (208) 635-5389
- NPI assigned
- Aug 20, 2009
- Last updated
- Aug 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | OIH | ID | |
| Mental Health Counselor | 101YM0800X | LCPC 3670 | ID | Primary |
Addresses
Primary practice location
2151 W Hayden Ave
Hayden, ID 83835-7414
Mailing address
2151 W Hayden Ave
Hayden, ID 83835-7414
Phone (208) 661-1776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OIH | ID | MD | Addiction (Substance Use Disorder) Counselor |
| LCPC 3670 | ID | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1699907907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2151 W HAYDEN AVE",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838357414",
"telephone_number": "208-661-1776",
"fax_number": "208-635-5389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2151 W HAYDEN AVE",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838357414",
"telephone_number": "208-661-1776",
"fax_number": "208-635-5389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURVIANCE",
"first_name": "VICTORIA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-20",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ID",
"license": "OIH",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LCPC 3670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayden, ID
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- Lady-Jean M Ramsey, DMD
- Kateri Picard Ray
- Jacob C Reedy, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.